| NPI | 1295350015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: FL pn5214949) |
| Additional Taxonomies | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2020-06-08 |